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1790 Silver Bell Cir
CITY OF EAGAN 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner. Address: Site Address: T "? r ? re . Plumber: Meter No.: - Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: BY Date Paid: Date of Insp.: Insp.: CITY OF FAGAN SEWER SERVICE PERMIT r 3795 Pilot Knob Road PERMIT NO : Eagan, MN 55122 . DATE: Z-ping; No. Of Units: Cwner. Address: Site Address: Plumber: agree to comply with the City of Ea gan Ordinanees. Connection Charge: Account Deposit: Permit Fee: Surcharge: B Y Dote of Insp.: Misc. Charges: Total: Insp.: Date Paid: - . CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 REC<IVED FROM AMOUNT $ H DOLLARS loo ? CASH ? CHECK FOR J FUND CODE AMOUNT Thank You ? By White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 PHONE: 434-8100 N2 6676 BUILDING PERMIT Receipt # Ts 1? MrA for FM Vnl?w I7nFo Site Address Lot Block Sec/Sub. Parcel # ? Name _ W 3 Address 0 o Name ' on r- Z o`V Address Name _ Address Erect ? Occupancy Alter Q Zoning Repair Q Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grade ? Depth ft. Approvals Fees Assessment Permit Water & Sew. Surcharge Police Plan check _ Fire SAC Eng. Water Conn. _ Planner Water Meter - Council Road Unit - 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit Is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Penek # Deft Iwwd pwmkittee Plumbing oZ '2 7 --Z O - T c J k I\so f\ 'P I Mechanical 075 Ix 7 - -*O INSPECTIONS DATE INSP. Rough-In Final Footings Date Insp. Dote Insp. Foundation ray inaF I _ / Plumbing Mechanical Remarks: ???? ? 7 Q ?? .uro'??d' ? ? ? v B.^??y? ?? liqr? Receipt PLUMBING PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Ce fi l/D i ld Bath tubs sspoo ra n e S i T Lavatory ept c ank f S Shower tner o W ll Kitchen Sink e Urinal/Bidet Oth Laundry Tray er Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Permit No. Fee S/C Tot. Receipt MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly 1. Date 2. Installation Cost 3. Job Address Lot Blk. 4. Owner 5. Contractor 6. Address 7. City 8. Building Type: Residential ? 9. Work Description: New ? 10. Describe 11 Type No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. r ng: an Boilers Mfg. Mech. Exhaust Unit Heater Mfg: Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : - for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. .Approved CITY OF EAGAN 464-8100 Permit No. Fee S/C Tot. Tract Phone State Zip _ Commercial ? Institutional ? Add ? Alter ? Repair ? CITY OF EAGAN Remarks Addition CEDAR GROVE #11 Lot 5 Rik Owner P.i r i i I C+ `, ke 11,C Q C1410t"d 1, street 1790 Silver Bell Circle Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. Q 1971 261.65 26.16 10 ) / . o STREET RESTOR. 1975 124.31 12.4+ 10 30 A010517 8-31-81 GRADING Strppt x87 . 52,.; ,18,. 7 A010517 8-31-81 SAN SEW TRUNK 6 1968 _ _ 60.0 , 2.00 a 9 A010517 8-31-81 * SEWER LATERAL ?qS 1 19493.96 98-79 * Water lat. & area 1975 5 WATERMAIN zn to 80.21 A010517 8-31-81 WATER LATERAL & area 1973 200.45 13,3T 1 b, WATER AREA * Storm Sewer T (1 1976 268.9 53.68 STORM SEW TRK :1 q 1971 3,3-56 1.67 20 /4 A010517 8-31-81 STORM SEW LAT (10 1971 22•37 1.11 20 it A010517 8-31-81 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 24819 5-26-81 WATER CONN. 335.00 24819 5-26-81 BUILDING PER. 6676 SAC 525.00 24819 5-96-81 PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ! 1 ?? i li i tii 1 I r <<:I I VCR Of L1. C.[R CUDAR GROVE 11 TN PERMIT SUBTYPE: INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. 1'E A ! APPLICANT: (611> 431 -4hJ9 TYPE OF WORK: HitI1 1)1Mts OADi41 u'a 1ar' /n7 REMARKS: SFPARAf PERMIT REQUIRFO OR AMY P10MR1146 WORK CONTACT -:'IATF [40ARD OF ELECTRICITY AT 496--9611`, RE [LFCIRFCA1. PFRMrl F L 7 I Permit No. Permit Holder Date Telephone ELECTRIC PLUMBING 3.7V HVAC Inspection Date Insp. Comments FOOTINGS ?-IZ-Cl7 !L FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL lU?? 7 GYP BOARD FIREPLACE ??- FIREPLACE AIR TEST 11 I! FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL RESIDENTIAL BUILDING PERMIT APPLICATION J CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651_681-467S Sew Const colon Rae kwunlg' • 3 o4stered site sun+eys _4xW y sq. IL of lot wt of hxw, and j4 roofed areas 420% nwirnum lolmye ap a 1 • 2 Copies of plan Wm wing bmm a amlow sloes: pour! found design, etc.) y I Set ofrretgy Calcu?ations • 3 o*ia d Tmo Pmmvakn Plan d ka pMedabe7/tf93 Rim;ast Defaq ?plborts setection s3leet (bldge witlt 3 ar,ies9. unit) Rsr1?drdtRenaic ateAfs 4 tomes cfpian t t detof yy 6onl"Wd addiipot?s. sow DATE l [ I l VALUATION (ExCLUO JOS ;Sli'! ADD.RESS -N- 0. _ : c? t ?\{I A ?- 0 CJV G-.lam If Ulti-FAMILY BUILDING, HOW MANY UNITS? PROPUTY TYPE OF WORK APPLICANT DtI V I,& t ADDRESS -1 , 11) : ^b i 1 Y` Or. bILL t' I r' 4f0 f?4*: q5- '_ 1 -' . CELL PHONE# 6 FIRfPLACI (;S) At t _2, -A 1°H, ! q?q' I",# N RESIDENTIAL BUILDING ONLY -FILL OLO CO MP ETEL Energy Code Category r ?I:N- NOOTA RULES 7670 CATEGOR (check orie) - residential Vanlitation Category :¦1. Worlmhes Energy Envelope Calculadons,'Suomitted i+i INNFWTA RULES 7672 New Energy Code WorksheetSubinMbd Piwinbft Contractor. Phone v* Pitinibfg'System ktclucles:. _ %to Sgttcner Lawn.Sprinlct _r ' 4atcr Heater No. of XT. Baths. No. of Baths Mechanical Contractor phchol* Iccl uric l .4)tccz_i Includes, slit' Conditioning 4 Heat Recover} System Sevier/Water Contmctor. Phone # Fcs : V0.00, All above inform0on must be submitted prior to processing of application. t hereby acknowledge that I have read 4his application, state that the informptiomis c_ effect, and agree: to dornpiiy with: all applicable State ofMinnesota Statutes and City of Eagan Ordinances'. , Signatfure of Applicaht Eertificates of Survey Received _ jYee Preservation Plan ReoQ d. No? Required OFFICE USE ONLY ? 01 Foundation Q' 02 SF.pwplting M 03 01 of_ ptex 13, ' ,02-pinx P7. 05 03-plex C 06 :u4-plex 31. New 13 32 Addition . ? '33: Alteration 0 34 Replacement Valuatfotr Census. Code, SAC Units Nbr. of Units. Nbr. of, Bldgs Type cif-lCon4t D 07 05-pt-ex D 13 16-plea Q 08 06-plex ? 16 Fireplace ? 09 07-plea 0 17 Garage D 10 '0'8}plex t 18 Deck 13 11 10-ptex< ? 1.9 Lower Level ? Z2 12-01ex Plbg_Y or _ N ? 20 Pool O 21 Posch (3=sea;) ?' 22, Porch/Adchi._ (4-se4.) R 23 Porch .(screened) ? 24 . Storm Damage ? 25 Miscellaneous 0 30 Accessory Bldg 13 31 Ext. Alt--.Multi O 33 €4 Aid - SF ?: 36 Multi 0 35 Int Improvement 13 38 Demolish,(Interiar) CI 44: Sitting 13. 36 Move Sidg_ 0 42 Demollsh -(Foundation) ? 45 F re jooair ? 37 Demolish; (Bldg)' .O. 43. Aerool. .? 46' Windows/Doors 'Demolltion (Ent kb Bldg only) Give PCA hendoUt to epplit:ant (2, C? Footiiigs:(ne%a bldg) Footings (deck,) l Footings (addition) _ Foundation _ Drain Tilt Roof _ Ice & Watt Finat _ Framing' Fireplace ` R.I. T AirTest Final Ir stibrion. Occupancy MC/E.S System Zoning !City. Water Stories Booster Pump Sq. Ft. PRY Length Fire SArinklered Width REQUIRED INSPECTIONS FinallC.0. 79 FintiiNe C.O. - Plumbing HVAC Ostler - Q?oolr _ Iytgs. _ Aiir;'Giis Tests - Final - -Siding -.Stucco _Stone Windows (newlreplacement) Approved By G ,.Building Inspector Base Peen Surcharge Plan Review MCISS :SAC City SAC Water-Ss?ply& Storage S&1111 Permit & .Surcharge Treatment Plant. ?lumbing, Parmi t, Mechanical Permit' _idense Search -opi.es 'ether Total i RENEWA4. BY ANE 350'73RD AVE. NE. FRIDLEY, MN. 763/502-4777 LICENSE# 20130983 OFFICE USE ONLY 0,01 Foundation M 02 SF.Owelling is 03 01 of , piex II 04. 02 piex 0.05 *piax 13.06 04-p1ex 00,7 05-plex 0 .13 16-piex ?X' W Or.-PleX _M 16 Fireplace O 09 07yplex 0 17 -Garage O 10 08-plex O 19: Dec 1 -11 10-pl6k E3 19. Lowsrlevei 13,12 12-plex Plbg_Y or_ N Q - '20 Pool 13 21, Porch (3-sea:) E3. 22 , PorchlAddrt.;(4-sea ) 0 23 Porch ,(screened) 13 24 Storm'Damage 13 25 Miscellaneous : 0 3Q,. Accessory 8109 17 31 Fad Alt= Multi' O: W. Ext. Alt- SF 0 36• Muld 0 -31 New. © 35 Int improvement Cl 38 Dentolisti.(intedor) U 44, Siding 0 32 Additlon 0 36 Move Bldg. C3 42 pemoiish (Foundation). - 13 4:5 Fir's Repair 0 `33 Alteration CI' 37 Demolish (Bdgr 0 .43 Reroof Q 46 WIndows/Doors 0 34 Replavernent 'Demolition (Entire Bldg only}-- Give PCA handout to app8ealtt Yaiuatio_n 00aipancy MCIES System Census, Code Zerrting City Water SAC. Units Stories Booster Pump Nbr. _of Units Sq. Ft. 'PRV Mt. of Bldgs= Length Fire Sprinklered Type of Coast W M REQUIRED INSPECTIONS Footings (new .bldg). Footings (dock) _ Final/No CO. Footings (addition) _ Flurnb* Foundation Drain Tile Roof Ice & Water Final _ Other Frap ing - _ Foal _ Fags _ Air/Gas Tests _ dual Fireplace M. _ Air Test _ Final _ Siding _ Stucco _ Stone Insulation _ Windows.(aew(replacement) Approved 'By . SuDding Inspector Base Fee Surcharge Plan Review 'MC/ES SAC City. SAC Water Supply &.Storage S&W Permit &.Surcharge Treatment Plant Plumbing Pemit Mechanical Permit License Search Copies Other Totail _ _ Finsilt.0l ? H?/AC RESIDENTLAL BUILDING PERMIT APPL.ICATION cr.moF EAt? M 38.30' P1LOr KNOB BD • 55722 = -- - --area 681-681;4$75 - 3, Bred sir atveye ?»lr>g : of lok sq 1L ot'houiei.end 4 Mw 2 ;i en (2osi ma>arlwm iol age ra?redl • ?etaf py ado6s Od?las -'j 1; ? • :2 popbs, of pM shaft be= & w*P ; poly tulddd64ft, elf.} • ? $ge sIpVOl110E4?tedot add?i0fi8 # t?eCli? r "? " - • I se d Energy C**km . wia* I 'weliile sefled?jr aep?c a ioi 3 coon of Tre Pion Plan N bf pW ted Aq VIM r • Rio JoW Dahl up=sYlemlr,el w (bldg wllh 3'or less u*) DATE U12=1 01 VALUATIGM i r JOB SITE ADORM WMULT14AWLY BUILDING, HOW MANY MIS? PROPERTY TYPE OF WORK K _t?S l C7g FIREPLACE(S) ©_ 1 PRCiN 9 APPLICANT C-floor . rND, '' sin el, n, ADDRESS PAGER # I NOV RESIDENTIAL, BUILDING ONLY FILL OUT:PPMPLETEL"11"' --, &OMY Coot Category _ MDTNESOTA RUM 7670 T oItY i (chec ef?e; Resident}al venwation ca"ory t Woftheoi Erww Enve" G.&uisuons S.WxiMed OubmMed I' MRgNFSOTA RLTM-7672 New Energy Code WoftheaSubs Plumbing Conkador. Phone* ' - - Plurnbing System Includes, _ Water Softener _ Lawn Spr lcr Fc?.•, ??9(3 QQ' Water Heater _ No. of ILI. Bates:' - ` - No. of Bad is Mechankcd Cor*040r. Phone # - - - Meclmnical System Indudes: Air Conditict ing - - - Heat Recovery System ' 1111 IC IL.? ? 1J_ _ Sewer/wcftr.Cotrh*Ct. Phone : l _L.-- Il _- AU above Wonriatbn must be stibiriitpad prior to processing of appoin. Bly -- l.hecby acknowledge tMlf l fittfr: read this aplicgtion;, state mat t9e tnforrncttlari isoir+e, s? to comply with cilt applicable State of tilinnesota Statutes and City of E09an'Ordinaiices. signature of Appftant CwMc a of Survey Reeelved Tree Preservation Plan Ftece ivsr# I?a# FteWtoad - ' touai OFFICE USE ONLY D 01 Foundation ? 07 Wpiex 0- 13 16-plex Q' 20 Pool Ci 30 Accessory Bldg ? 02 SF Dwelling CJ 08 08-plex-. 0 18 Fireplace D 21 Pofch (3-see:) ? 3.1 Ext. Alt-. Multi a 43 01 of _ plex 0 -09 '07,plex . 17 17 Garage: ? 22 Por*Addrr. (4-sea:) El 33 . EA. All - SF I:] 04 02-piex a 10 `04lex .0 16 De(* U 23 Pooch (screened) 0 36 Multi O 05 03199x; 0 i1 10-pier '0 18 : Lower Level 0 24 S.fo nn. Damage 13, 06 04-plea 0 42 12-plex . NWj or, N 0 23 Miscellaneous 0 11 New l3 35, 161 l nom ment 0 38 1 Dern*b (interior) ? , 44 Siding '0 32 Addition 17 '38 Wve Bldg. 0. 42 Denndlish .(Fxxmdatbn) ? 4$ Fire Repair 0' 33 Alteration O 37 Demolish (Bldgr ? 43 Reroof' 0 46 VVlrwbws/Doors ? 34 Reptaoemerat "Dwreolttioao (Etraire Bldg only) -Give PCA handout to. applicant Valuation, t7ccupancy MC/E3 System Census Code Xonfng City Water SAC Unas S.tonies Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. gf!81dgs: Length Fire SpOnklere+d. Type of Const Width REQUIRED INSPE=O!NS Footings (fievv bMg) Footings: (deck) Footings (addition) Plumbing, Drain Tile Roof ke & Water Final Other Framing P001 FiMlace :_ -RBI: - Air'i'est -Final Insulation windows (newlreplacement) _ Final/C.O. Finahtva CA fi:VAC Foot _ Ftgs _ Au%Gas Tests _ Final ' Siding _ Stucco - Stolle Approved Base Fee Surcharge G5 Plan Review MWES SAC. City SAC Water.Supply & Storage S&W Permit & Surcharge Treatment Plant PiU-mbing Permit Mechanical. Permit License Search. Copies Other Building Inspector Total 1 2(1 k4 . RESIDENTIAL BUILDING PERMIT APPLICATION - - COY OF EAc3Atr1 a a 3830 PILOT KNOB RD -W122 J 63'f.-68'65 `,J • q-7- • ? ?9 ? D 94 a-'Qi1cf??F. ?; of (+ou?'ond ? rooted ueas tot cavorager alWN?d1 MOW slaw,; PXMWioW des0a. et ).. 2 ==y =10m,& 1 • 3 OOpBS f TIIBB Pre vd?OA'Pfe?'if 1d piaW vbr711M • i#ifn_JOhctQeEa9 OPGbns sglldiotx 81?edl (Ltildpd Vd?h,3 orl? un? DATE. JOB- SITE ADDRE: IF WLTI-FAMILY PROPERTY OWN! TYPE OF WORK A AP.PUCAMt A, ADDRESS /44 PAGER ?_ i aoet ot>?+e?Y ?t ?lld edd?ons .. 1 ale turyey,Ynre?toe t?d?.de + Iii?id?le;lflioche:?stvpd?YaeQl?sy6?em?fi0fe?6o?;, ? ;VALUATION .HOW MANY UNrrs? CELL PHONE1 -,- -' - fAX' - i 1 L PTV RESIDENTIAL BUILDING ONLY .FILL OUT OtAPL ;ELY Energy Code'Cotegory MIINMOTA RUIM. 7670 CATMOXY 1 (check ono) - RWdentlai V, eWatfon CWepty- I Worlrsinee ? --?? ,?.-.i nvelope .C.sicuMlon8 &AMMed: y? MINNESOTA RULES 7672 New Energy Code Workoleet OubmMed - . NlumlaiinB Clnhactor . Phon11;' B .0! 'fee; plum S bing Includes;. Water Softener _ Lawn-Sp inider. Water Heater NQ, of kr. Bad - NO. of Baths = Mechwical Cordroctol;. Mechanical System Includes- Ait Couditionitzg Heat Recovery Sps?em Sewei/Viater Contractor. Rhone # - - . , Phase #. - - Alf above infam fion must be subrnltted,prfor to pm-owing-of OPPkOWn. I . hereby ac mowiedge that l have read this appo ofron, stafe? ttxit Wth di applicable State of Minnesota Statuies-and City of E090r couoct. .?. CartifcatWof Sutvey'Rec &W Tree,Preservation Piwft_ WW_ _ NO R.eQ4 W_ OFFICE USE. ONLY D 01 Foundation ? 07 05-plex -0 02 SF Dwelling a 08. 06-plex 0 03 01 of ^ plaax 0,09 07-plex d 04 02-plex- O 10 084plex. 0 05 03-plex . d 11' f0-plex M06 :04-pfox 0 12': 12-plea 0 31 New D 35 A 32 Addition: 0 36 13 34 Alteration 0 37 a 34 Replacement Vski.w tiorr Census Code SAC Units Nbr. of Units Mr. of Bldge Type of 'Const 0 13 16-0ex 0 20 Pool ? 16 Firepfaael 13 21 Porch (3•seas). 0 17 Garage 22 PorchlAddn. (4-sea.) E! 18 Deck b 23 Porch (screened) O 19 Lower Level El 24 - Storm Damage Plba ;Y or - N. ? 25 MiscelleneoM 0 30. /t ry 81dg d 31 EXL Alt -Mufti M `33, Ext. Alt - SF 0 36 MUM Int Improvement C1 '38 Demolish (interior) 0 44 Move-Bldg. 13 42 DemoUsh (Foundatioo) 0 45 Dentolfsh (Bldg)' 0 43 Reroof 0 46 Temol tion (Entire Bldg.onjo - Giva PCA handout to-appftant 00pupency 1L?" MCIES. Systern Zoning ?P,- I_ City. water Stories t Bopsw Pump Sq. Ft: -? PRV Length Fim: SpriAklered Width REQUIRED INSPECTIONS Footings (now MW _ Final/C.O. Footings (deck:) Fit3sllNo. C.O. -Footings (addition) Plw&ing Fouadatiou HVAC Drain Tile hoof ke &. Water i Final 09M . Pram n Siding Stuce'a -sum Fir*acr. _ R1 ` Air :Test Final ?[ uWation Approved By Gc -- Buiiding:lnspeotor Base Fee Sw Marge Plan Review MCIES SAC City SAC Water Supply &Stowe MY Permit & Surcharge Treatment Plant Plumbing'Permft. Mechanical Permit Li*nse:.Search. C©ples ' Othar Total /0j ? FC t / 7- 5 ti l v -- _ $idin?g fire Repair WMdo+aal0oors - Fool - 'Ergs Air/CmTests - Final _ 1?Vindows:(new/replacement). CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT APPLICATION N2 6676 Receipt * "- gl;? To be used for SF DWG/GAR Est. Value 51,000 Date M ay 26 19-n- Site Address 1790 Silver Bell Circle Erect )D Occupancy R3 Lot 5 Block 3 Sec/Sub. Cedar Grove 11 Alter ? Zoning Rl Parcel * 10 16711 050 03 Repair ? Fire Zone NA Enlarge ? Type of Const. V W Name Brian Chapman Move ? # Stories 3 Address _ Demolish ? Front 45 ft. ° City Phone Grode ? Depth 46 fr' p Name TA genfeld Carl '^tion - Approvals Fees oG _ Box 483 Assessment All 5/21 $]rmit142•00 ° Address 437-8007 Water & Sew. .50 Surcharge 25 Ci Baetinge Phone 00 71 Police Plan check - F ww W Name Fire SAC 525.00 ~ Address Eng. Water Conn. 335. 00 aW City Phone Planner Water Meter 60.00 Council Road unit 185.00 1 hereby acknowledge that I have read this a licotion and state that Bldg. Off. the information is car nd agree to c mp y ith all applicable APC Total 1343.50 State of Minnesota atutes nd City of an rdina es. Signature of Permitt A Building Permit is issued to: Bri 52 Cha on the express condition that all work shall be done in accorda e i h all app Late of Minn eso a Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN CInclude 2 sets of plans, 71 W ite plan w/elevations & c ?A BUILDING PER%11T APPLICATION et of energy calculati To Be Used For y... Valuation 6-1, 04,60 Date S - 19, 0 Site Address N i2 41 Q% # // OFFICE USE ONLY Lot 5- Block sec./sub. arect __X_ Occupancy - Parcel #: 7// 46;2 D? Alter Zoning Repair Fire Zone N R Owner: ?,c /'D o_. -?• - Enlarge _ Type of Const. V Move # Stories Address: City/Zip Code: Derolish _ Front ys ft. Grade Depth y/ ft. Phone #: APPROVALS FEES Contractor: f? 3 _ y o ?G I K s tAssessmE'nts / Permit /Y?.od T ?gater/Sewer Surcharge S. 5-0 Address: Police Plan check 7/. 66 SSo33Fire SAC sas Oo City/Zip Code: t Eng. Water Conn. a36.eO Phone #: 7 - sinO e Planner Water Meter td OO Council Road Unit / 8500 Arch. /ing.: Bldg. Off. Address: APC - City/Zip Code: Phone #: TOTAL ??,??ef3 ??,Mo{ n ,?(l0 L5,33,C,?,l? ?? se us request void ?S ?? ? 18 months from C Date of tJ(t Request July 15 , 1981 Fire No. T49320 1, asa Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 1799PSi 1 yer Bell Circle City Eagan Section Township Range' County Which is occupied by not occupied - Langenfeld & Sons. Contractor (Name of Occupant) Is a roughin inspection required on this job? No ? Yes OK Ready Now ? Will Call ®X Power supplier Dakota Electric Address Farmi ngton Electrical Contractor S. P. & H. ELECTRIC Contractor's License No. 40008 (company Name) Mailing Address 16 Lev' Avenue E t, Hastings MN 55033 f e rl Con r Making This Installation) Authorized Signature Phone No. 437-8535 tr al Contra or caner Making This Installation) ,Jg yam, ?t p Q /?[r,?M COPY This inspection request will not be accepted the ?J ?f State Board unless proper inspection fee is enclosed. mmnesom state boars or tiectncity Griggs Midway Bldg. - Room N191 1821 University Ave., St. Paul, Minn. 55104 - Phone 297.2111 'REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST ES-000011--..02 025 D 1 c T 49320 Type of Budding New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home Ki ? ? Range ? Temporary Wiring ? Duplex ? ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Furnace , Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Farm ? ? ? List List Other ? ? ? ethers Here Others Here COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Amps. 1 0 Amperes 0 to 30 Amperes 101 to 200 Amps. 00 Amperes 31 to 100 Amperes Above 200_ A m s. Amps. 00 Above 100 Am s. Transformers 4 ontrol Circ. Partial or other fee Inspection Minimum fee Remarks TOTALF E .7.4 Z3.0 I, the Electrical Inspector, hereby certify fi been U e. e (Final) This request void 18 months from ? 70? 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ZZ 1 D V Site Street Address t7fd Si L''v-e-F< (3C I U n it # ? / c ? Property Owner Div Telephone # k,;-[) ?O p p- ?ayy Contractor-MI) ' ;kk >?IGGl , /?`t Telephone #(6"-t)??QJ/9 Address 3a-?q ofs//Y' City / S ? StatellI' Zip §-SZ 33 The Applicant is: - Owner ,Contractor -Other Alterations to existing dwelling -Add fixtures to rooms, excluding water softener and water heater -Septic System Abandonment -Water Turnaround (add $121.00 if a 5/8" meter is required) Other: Uq--K 9V5 0 e c-Lt2g. $ 50.00 Water Softener - Water Heater - replacement _ additional $ 15.00 Lawn Irrigation System RPZ_ new _ repair -rebuild $ 30.00 State Surcharge $ .50 Total p ? S? $ JU I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. Applica'nt's Printed Name Apggio13nt's Signature t. i ,O- Do""- \ .lp ,z M('i o 5 GP?tiz ?? o c 1 \ cy 4 ? pybr*0.oc6 Esc ' 2'? o\ GR /Z. C) AN SCALE FIV,' ANP FLY? Lot c ec;,r DPi• ,w,,,.. 1-2 Family Residential Building RESIDENTIAL "COOKBOOK" WORKSHEET 3$8 - /feSd ;t- S7? E/9?N?j ?r?. Ss'/z Z 2 The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the rcqu' cots of the Minnesota Energy Cade. MINIMUM REOUIREMRNTC for 1611nnlrhnnWs nneln... Entry Doors 1-3/4'' solid wood w/ storm Ceiling with energy truss R-38** Rim joist R-19 door or equivalent (Min. 7%" top plate to sheathing) Foundation Windows* Insulated Glass w/1/2" gap in Ceiling with low heel truss R-44** Floor over R-24 wood or vinyl frame * unconditioned space Include square footage in calculation of Window/Door Area Ceiling-no attic R-38 w/ R-5 sheathing to determine above grade Window U-Value. -••.••••»....... v..v.wnu..., a. .. nuGl ll0°IK i Conditions Window and Door Area y 100 x o?/S a 6 .So ?e2 % WINDOW U-VALUE : 0 , 2-/ As % of Exposed Wall Area Above Grade Window and Gross Wall Area Window/Door Area Source: NFRC or ASHRAE 1993 Handbook FouodationWindow/Door Area t &4A Vraairltlf IWVXT>n.' , ar Check Wall e WALL TYPE ..-.-. ....,.. .a,.aiv rr v-rna..Vra MAXIMUM WINDOW AND DOOR AREA % OF EXPOSED WALL AREA Type Us d 126% 14%' 16% 18% 10% 22% 24%' 26% 28% 30% 32% 34% TYPE A 2x4 framing, R-13 insulation, sheathing R-7 or greater. 0.55 0.47 0.41 0.36 0.33 0.30 0.27 0.25 0.23 0 22 0 20 0 19 TYPE B 2x4 framing, R-I5 insulation, sheathing R-5 or greater. 0.52 0.45 0.39 0.35 0.31 0.28 0.26 . 0.24 0.22 0 21 . 0 20 . 0 18 TYPE C 2x6 framing, R-19 insulation, sheathing Tess than R-5. 0.48 0.41 0.36 0.32 0.29 0.26 0.24 . 0.22 0.21 0 19 . I S -5718- . 0 17 TYPE D 2x6 framing, R-19 insulation, sheathing R-5 or greater. 0.56 0.48 0.42 0.37 0.34 0.31 0.28 . 0.26 0.24 0 22 . 0 21 . 0 20 TYPE E 2x6 framing, R-21 insulation, sheathing less than R-5. 0.51 0.43 0.38 0.34 0.30 0.28 0.25 . 0.23 0.22 0 20 . 0 19 . 0 18 TYPE F 2x6 framing, R-21 insulation, sheathing R-5 or greater. 0.58 0.50 0.44 0.39 0.35 0.32 0.29 . 0.27 0.25 0.23 . 0.22 . 0.21 This ta ble contains interpolations of the values in the E nerav C ode_ Pan 767(1 (1,171 o .h.. I This is a summaryonly. Other requirements may apply. See the Minnesota Energy Code. Questions? Call Department of Public Service Information Center at 612296-5175 or 1.800/657-3710. 215/96 BP . 1-2 FAMILY RESIDENTIAL BUILDINGS PACKET , - 'A ENERGY 1-2 Family Residential Buildings SUMMARY OF BASIC REQUIREMENTS ROOF/ .INWALLS, FLOORS: • Either meet "Cookbook" criteria as outlined in Residential "Cookbook" Worksheet OR meet U-Value criteria as outlined in Exterior Envelope U-Values Worksheet. O3MRENVE .OP . RrMRIA• • Slab on grade floors must have continuous perimeter insulation of R-10 to depth of frostline. • Foundation walls must be insulated with R-10 minimum from top of wall. • Loose fill insulation installed must provide the required performance at winter design conditions. EFFECILVENIESS OF REOMMED THERMAL INSULATION- • Building design must meet Category 2 requirements for vapor retarder, air leakage and wind wash barriers, and ventilation. DUCT INSULATION AND CF.ALIN • Insulation for ducts encased in cement or within ground must be R-5. Insulation must be installed on bottom and side of plenums. • Ducts installed in attics, garages, exterior walls or unheated crawlspaces must be R-8, minimum. • Return air ducts conducting air into a furnace through the same space as the furnace must be sealed continuously airtight. • For ducts running outside the vapor retarder or of greater than 0.25 inches water gauge pressure, all transverse joints must be sealed. EIVAC PIPE IN TI ATION: Insulation Thickness, Inches Pipes 1" and Pipes System Runouts• Less 1-1/V to 2" Heating /] 1!,A 1!/z Cooling (Suction) % % 'Applies to runouts not exceeding 12 feet in length to individual terminal units. SERVI . WA R FlEATING: • Either the first eight feet of both inlet'and outlet pipe must be insulated with % inch thick pipe insulation or heat traps must be installed. • Energy requirements for swimming pools and spas are in Part 7670.0710, Subpart 5, page 55 of the code. MAT . IA C AND INii ATION INFORMATION: • Materials and equipment must be identified so that compliance can be determined. Completed insulation receipt attic card must be supplied near access opening. • Manufacturer manuals for all installed equipment requiring preventative maintenance for efficient operation must be provided. • Insulation R-Values, window and door U-Values, and heating and cooling equipment efficiency must be clearly marked on plans. This is a summary only. Other requirements may apply. See the Minnesota Energy Code 2/996 Questions? Call Department of Public Service Information Center at 612/296-5175 or 1.800/657-3710. 0 i A ENERGY All Buildings SUMMARY OF BASIC CATEGORY I AND CATEGORY 2 BUILDING REQUIREMENTS FOR INSULATION PROTECTION, AIR TIGHTNESS, AND VENTILATION MINIMUM: All buildings must meet the following minimum code requirements: VENTIL TION: A Category 2 building is one where infiltration and passive ventilation (operable windows) are relied on to provide necessary year-round ventilation. If one or more of the Category I measures below is incorporated into the residential design, however, a residential mechanical ventilation system as specified below must be installed. VAPOR RETARDER' A vapor retarder, also known as a moisture barrier or vapor barrier, must be installed on the warm side of insulated ceilings, walls and floors. Polyethylene vapor retarders must be 4-mills or thicker. The code requires a vapor retarder to be installed only on rim joists that are susceptible to condensation from moisture diffusion. AIR BARRIER: A barrier against air leakage must be installed to prevent leakage of moisture-laden air from the conditioned space into exterior ceilings, walls and floors. • Plumbing and heating penetrations must be air sealed. An air barrier must be provided behind any tub or shower that is located on an exterior wall. • Air sealing must be done at all dropped ceiling areas, chimney flues, ventilation ducts, and other fire stops that penetrate the vapor retarder. • Holes in the building envelope for electrical and telecommunications equipment must be air sealed, including the service entrance, wires, conduit, cables, panels, recessed light fixtures, and fans (where vapor retarder is penetrated). • Joints in the building envelope must be sealed, including around window and door frames, between wall cavities and window or door frames. • Tested air infiltration rates must not exceed 0.34 cfm/square foot of operable sash crack for windows, 0.5 cfm/square foot for residential doors and 1.25 cfm/square foot for commercial doors. WIND WASH BARRiF R: An air-impermeable barrier must be installed at the attic edge (baffles must be rigid material resistant to wind driven moisture); and overhangs, such as cantilevered floors and bay windows. I air rivtasi : %-allegory I tsuurltngs meet all requirements as listed above n[us the following: RESIDENTIAL HANI si NTI ATION SYSTEM FOR RESIDENTIAL BUI DINGS A system that, by mechanical means, is capable of introducing and distributing outdoor air to all habitable rooms and removing indoor air at a rate of not less than 0.35 air changes per hour or 15 cf n per bedroom plus another 15 cfm, whichever is greater. AIR L..AKAGE BARRIER: A barrier against air leakage must be installed to prevent leakage of moisture-laden air from the conditioned space into the building envelope: • Electrical boxes and fan housings must also be sealed. • All rim joists, band joists, and where floor joists or trusses meet outer walls must be sealed. • The top of interior partition walls that join insulated ceilings must be sealed. • Joints must be sealed between wall assemblies and their rim joists, sill plates, foundations, between wall and roof/ceilings, and between separate wall panels. WIND WASH BARRIER' All exterior joints in the building envelope that may be sources of air leaks must sealed. This is a summary only. Other requirements may apply. See the Minnesota Energy Code. 2/5/96 Questions? Call Department of Public Service Information Center at 612296-5175 or 1-8001657-3710. 0 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan (a i { L} 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ` New Construction Requirements RemodelReoair Regulrements Office Use Only 3 registered site surveys showing sq. % of lot sq. it of house; and all roofed areas 2 copies of plan Cent of Survey Recd _Y -N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Reed _Y -N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 she survey for additions & decks Tree Pres Required -Y -N I set of Energy Calculations Add6m- indicate ifonsde sepfk system On-site Septic System _Y _N 3 copies of Tree Preservation Plan ft lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date 641 / /,5- / Site Address 119 D4 b' --5 jt{?C :& n Construction Cost 1 JOO191 AZ-1-1 tl l-^id`'- Unit/Ste # Description of Work (? r?t2rlq v Multi-Family Bldg - Y NO N Fireplace(s) LC 0 - 1 - 2 PropertyOwner ?1 a. f a '?g r Telephone # (t,5 / )lobs -9z-4j4 Contractor wC3f' w? Z 5j" Address a`I ql State MAI ?? A City W lr i Lt r L M jr C Zip 5T11 6 Telephone # (? /) a1 g3 -a QZ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 - Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y -k N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Telephone #( Telephone #( I hereby apply for aagnAA A ' ermit and acknowledge that the information is complete and accurate; that the work will in conformance ' the ordinances and codes of the City of Eagan and the State of MN Statutes; I underst this is not a ut only an application for a permit, and work is not to start without a permit; that the wor a to actor ane with the approved plan in the case of work which requires a review and approval of plans. c?- Applicant's Printed Name Applicant's Signature OFFICE USE ONLY 4 Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - G ive PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const _ Width Footings (new bldg) Footings (deck) Footings (addition) _ Foundation _ Drain Tile Roof Ice & Water Final Framing Fireplace _ R.I. - Air Test - Final Insulation Approved By: Ew? Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIRED INSPECTIONS Final/C.O. X Final/No C.O. _ Plumbing _ HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco - Stone _ Brick _ Windows Retaining Wall Building Inspector lS fr' te- s'?6x /?- ?j-o(v ,. Q ? c?mow V 1- aa, IV J 3L ???{avE V d PEy??ao ? `.L N oV r to ?" r®o /D . Y , /Z.o C01LiiFlCtfl K ?I ,z"k.ZC ?? " SCALE ?q_i'-0'• ??s ?.S'3-fl.?,CT?C?I? 1?1u•I•e 1?e??e1.?Le ? Gsl-??-cRS? AN F(F LOT CEC DRA PERMIT #: ?T53G) CITY USE ONLY RECEIPT DATE: 1KSIDENTIAL M1±Cf1 "ICAL PFJtMPP APP11CATION crrYof EALa H 3630 PHMT KNOB RD EAGAN tE 55112 651-681-4675 }a-3?_ol 5P Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: t ajat d C)' SITE ADDRESS: 1 1q(?7' ' 51 it y? /If 0 Ct r • OWNER NAME: TELEPHONE #: 1 (D'5 I ! 68- 9O L-1 (AREA CODE) INSTALLER NAME: Wohlers Southside Htg. & Air., Inc. #: 6950 W. 14631 St., #106 (AREA CODE) STREET ADDRESS: Apple Valley, MN 55124 (952) 431-7099 CITY: ZIP: Plarp a cherk mark nett to the nermtt wnrk tvne New residential dwelling unit under constructionand not owner/occupied $ 70.00 Add-on, modification or alteration to existing dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Nature of work: L7l CSC ?Y (?QC? l?t? h C ,cx7J L m L. &UVAOCIb• State Surcharge $ .50 Total $,5n.50 Reminder: Call for inspections. ,=? d O6'1>,LmA-----' MGNATURE OF PERMITTEE Updated 1/01 CITY USE ONLY PERMIT #: APPROVED BY: RECEIPT DATE: INSPECTOR COMMEaCIAL MECfIi4NICAL PF.UIT AMICATION CITYOP EALGM 3$30 PILOT KNOB RD KAGM, MN 551 E8 651-661-4675 Please complete for: all commerciallindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: WORK TYPE: Specify Nature of Work _ New construction - Interior Improvement Processed Piping _ Install U.G. Tank Remove U.G. Tank When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing Iinspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee Contract price: $ x 1%= $ (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ PHONE #: (AREA CODE) STATE: ZIP: SIGNATURE OF PERMITTEE Updated 1/01 214? - `?, ppiab ,yY' w? 6-0 &S o ? .De Ck_ /2.0 J SCALE ': F?s; ANN Fir. Lol CEt blo ? U6/U7/ZUU1 171U 1Z:JU CAS 104 011 4400 rhAhWAL riYANVtKbhly re -', al BY"DBRSW June 7, 2001 City of Eagan 3836 Pilot Knob Road Eagan, MN 55122 To Whom It May Concern: Elder Jones is authorized to pull building permits for Renewal by Andersen- Please allow Elder Jones to provide this service for us in Eagan. This authorization is valid for any date beyond 6/6/01; until a Renewal by Andersen manager expressly revokes it in writing to the City- I request this authorization be accepted expeditiously, as to not delay in the processing of our building permits any further. Plcasc call me if there are any questions. I can be contacted at 763-502-4706. Your immediate attention to this matter is appreciated. Sincerely, and R. Rau nstallation Manager Renewal by Andersen Corporation Ce! Kara-Alder Jnneg Notary PMinnesI61en EentrC UUZ/UUZ MEGH DA M. EDIIMIA.L Received Time Juo. 7. 1:07PM Mkt.'Y.: X(:;(:'X%Ym`:::+.k':*?R?;f'if}Y%X'y:ii'** A iYi;,Q CITY OF EAGAN ;QATc:;. 09/02 /97 TT.r'EN 0:5006 I Y, n ?!Ai•+'...I CHIT?L: NITI_i...l::i? fv(li'?? 7 32M 9001 1790 SILVER BEL 358.75 3422 9000 1790 SILVER r%1-L 233„19 °i°'_ 9001 090 SILVER BEL MOD Tot Receipt Amount, 604.94 C'RO30!I 63 USER Tur NANCY 1F:?',;r5'Fyr'?:h;Y,:;K?uY,(X?iY,f9R'"Ci;?)?ii'1•;K•i?Y ){i4 iVi?f)L??.VY'y<:`:?:;k)? ?{W.>?;4 CAY04OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: BUILDING Permit Number: 0 3 0 7 4 7 Date Issued: 09/05/97 1790 SILVER BELL CIR LOT- 5 BLOCK: 3 CEDAR GROVE 11TH P.I.N.: 10-16711-050-03 DESCRIPTION: B"wilding-.Permit Type SF ADDITION rBuiiding-W6,r4 Type NEW `Census Code -'° 434 ALT. RESIDENTIAL k. 6 I Eh 1} ?? f ?r CE'H h REMARKS: SEPARATE PERMIT REQUIRED FOR ANY PLUMBING WORK CONTACT STATE BOARD OF ELECTRICITY AT 496-9615 RE ELECTRICAL PERMIT FEE SUMMARY: VALUATION $26,000 Base Fee $358.75 Plan Review $233.19 Surcharge $13.00 Total Fee $604.94 CONTRACTOR: - Applicant - ST. LIC OWNER: CHAD MILLER CONST 14314539 2004424 PAULSON DAVE 8388 144TH ST 1790 SILVER BELL CIR APPLE VALLEY MN 55124 EAGAN MN (612) 431-4539 (612)688-9244 I hereby acknowledge that I have read this application and state that the inl=ormat on is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordihances. AP ICANT/PE MITEE SIGNA URE ISSUED IGNATURE 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) 17 O y? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ( 681-4675 nstruction Requirements Remodel/Reoair ? 3 registered site surveys ? 2 copies of plan # 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions • 3 copies of tree preservation plan it lot platted after 71"3 required: _ Yes_y No DATE: 9Z CONSTRUCTION COST: r" 30 Q °? DESCRIPTION OF WORK: 0'9dd,'7L/0A,1 14, STREETADDRESS: LOT BLOCK S -/b,25 _ SUED./P.I.D. PROPERTY Name: ByZI&- -V, /Yftf?y /Au ?SD/r/ Phone #: 6-jS8- 9 z y,5` OWNER Street Address: 17,90 City: Elf9A/? State: AV, Zip: S?JZz CONTRACTOR Company: el4dl Al/E,P Z, J-X Phone #: -1131-zs-.- 2_ Street Address: 838E 7z-:fx License #:o?oh 51?cZi47 City: State: ARCHITECT/ Company: AW Phone #: ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer & water licer.-ed plumber (new construction only): Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. 11 Signature of Applicant: FZ r52;5, r2n"n 1 OFFICE USE ONLY Certificates of Survey Received Yes No SEP 21997 Not Required Tree Preservation Plan Received Yes . No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? ? 05 SF Misc. ? 10 _ plex ? 15 Deck WORK TYPE ?,? 31 New ? 33 Alterations ? 36 Move ,X 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft, sq. ft. Footprint sq. ft. Planning Building Engineering Variance -L_ Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC 4{ i . SAC Units Valuation: $ Z(, mn°, co 420X 5-4 ? ?/ G,-eo, 426) X e, r Z 1 S-ZO- 00 `T'`7q-Ii ZS"I 2?. cap 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit 2 L S BL CITY USE ONLY RECEIPT#: 9S3 3 0 3 ? SUBD. UXAL / RECEIPT DATE: S 9 1998 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, HN 55122 (612) 681-4675 Please complete for. ? single family dwellings ? townhomes and condos when permits are required for each unit D backflow preventer far underground sprinkler system FIXTURES EACH # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x Floor Drain 3.00 x = Gas Piping Outlet ' minimum -1 3.00 x = Rough Openings 1.50 x Water Softener * for dwellings under construction 5.00 x - Water Softener * for existing dwelling 20.00 x = .. . U.G. Sprinkler * for dwelling under const. 3.00 = U.G. Sprinkler * for existing dwelling 20.00 Alterations * to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' MPC lic. 75.00 = (new and refurbished systems) _ Private Disposal Systems * Abandonment 20.00 - RPZ (new installation only) 20.00 = STATE SURCHARGE .50 TOTAL '90.50 6 ----------------- -------------------- -------------------------- ---------- 1hereby acknowledge that I have read this application, state that tha information is correct, and agree to comply with all applicable City of Eagan o finances. It is the applicant's respr - `* Eagan assumes no liability for any damages caused by the City during its normal operational and n PAULSEN, K. ter this permit within City property/right-of-way/easement. 1790 SILVER BELL CIRCLE SITE ADDRESS: EAGAN, MN 55122 (612) 688-9244 . OWNER NAME: _ INSTALLER NAME: ?hlnlu uom &ArlES)aGI TELEPHONE#:_9Z7'7y3J STREET ADDRESS: Z-10-5 6sorQ-FIE1--12' /TVc ??O/ CITY: ??II L)t tppuS STATE: /At 1j ZIP: 65408 SIGNATURE CDIPERMIT FORMS/RPLBG PERMIT (RES) - 1998 L J BL 3 CITY USE ONLY RECEIPT#: W/ 9.P SUBD. t ?,I Air ,qtU RECEIPT DATE: /0' 0- ! 7 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681.4675 Please complete for: . single family dwellings townhomes and condos when permits are required for each unit backtlow preventer for underground sprinkler system FIXTURES EACH NO. TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener * for dwellings under construction 5.00 x = Water Softener * for existing dwelling 20.00 x' U.G. Sprinkler * for dwelling under cont. 3.00 = U.G. Sprinkler * for existing dwelling 20.00 = Alterations * to existing residence <Q` _ Water Turn Around 20.00 = Private Disposal System * oak Cry lic. 75.00 = (new and refurbished systems) Private Disposal Systems *Abandonment 20.00 = STATE SURCHARGE .50 F:y?iS?"1 f r,wer ?a??h TOTAL ao..sa I hereby acknowledge thatI have read this application, state that the information is oorrecL and agree to comply with all, applicable. City of Eagan ordinances. It is the applicant's responsibility to notify the property, owner that the City of Eagan. assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facitites constructedunder this permit within City property/right-of-way/eas9gWt, SITE ADDRESS: OWNER NAME: INSTALLER NAME: TELEPHONE #: Q l _ STREET ADDRESS: II e2yo. ii ,, n, CITY: La.rm I rla7611 STATE: It (-?n5? - \ (zip: {? n n ? l I?JC,GcA e SIGNATURE OF PERMITTEE ?v o, \b o os 4/ - n LAI?r\I " SCALE p, :1,-0,. ti G? P? kQaoc6 z 12.0 I -1-1?1Z AN roW Lol £ CEDA DPAV 3K Lk` ry?u ?J'.,'11ik) ,t? (s ppNin %'vi CITY OF DATE: May 21, 1981 This supplement is provided to assist the appiice-nit in computing the EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This infornt3tion is required so the BUILDING OFFICIAL can determine that the submitted plans ea.-f.?iy tilth the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6001). It is the APPLICANT'S responsibility to accurately and completely ccWu?o tho data; reflect the proper DESIGN CNI"i ERIA in the plans; submit product specification, as needed to support the "R" end "U" factors used; and to assure that construction is necompiishod per the approved plans. JOB LOCATION OWNER(S) PHONE CONTRACTOR Frank M. I.angepgsJ_d &sSODD PHONE 437-8007 A. Determine the Total Exposed Wall Area as followo: 1. Total wall window area 156 sq. ft. 2. Total door area _x57 3. Total sliding glass door area --- - 4. Total fireplace wall area RO 5. Total wall framing ares (sverage 10%) 1162 6. Total net wall area above floor 1217 7. Total rim joist area 14 Subtotal: Total exposed vjall crea above floor 1746 cq. ft. 6. Total foundation window area --- 9. Total net foundation area above grade 91 Subtotal: Total exposed foundation area: 91 so. Lt. GRAND TOTAL EXPOSED WALL AREA 1? slra- -?1 B. Multiply the GRAND TOTAL EXPOSED tyALL AREA X .185 = Item I Tg9.8S C. Determine the Total Exposed Roof/Ceiling Area as f;slows: 10. Total skylight area _-- 11. Total roof/ceiling framing area 98 sq. ft. 12. Total net insulated roof/ceiling area 890 GRAND TOTAL EXPOSED ROOF/CEILING AREA 988 sc? ft. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .04 - Rem 11 39.5'2 ynjf U fireplace wall U k int. air film 8" masonry ext. air film U = 1/2.55 = .31 s ? Fw R = 0.68 1.70 0.17 R = 2.55 ext. walls int. air film R = 0.68 1/2" gyp. bd. = 0.45 3-5/8" F.G. insul. = 13.00 1" urethane shthg. = 6.00 hardboard siding = 0.67 ext. air film = 0.17 U U = 1/20.97 = .050 R = 20.97 ext. wall framing int. air film R = 0.68 1/2" gyp. bd. = 0.45 3-1/2" softwood 4.38 1" urethane shthg. = 6.00 hardboard siding 0.67 ext. air film = 0.17 R = 12.35 U = 1/1,2.35 = .081 U rim joist int. air film RI= 0.68 3-5/8" F.G. insul. = 13.00 1-1/2" softwood = 1.88 1" urethane shthg. = 6.00 hardboard siding = 0.67 ext. air film = 0.17 R = 22.40 U = 1/22.40 = .045 K. Y3LtFi all. r U' f i " F ext. found. wall ' int. air film 12" conc. block ext. air film U = 1/3.35 = '.298 U ceiling/roof U = 1/41.78 = .024 U ceiling/roof framing U = 1/32.16 = .O31 int. air film 5/8" gyp. bd. 12" blown cellulose ext. air film int. air film 5/8" gyp. bd. 3-1/2" softwood 8" blown cellulose ext. air film Assigned value Taylor steel walk doors Assigned value Marvin insul. wdw. R = 0.68 = 2.50 f,. = 0.17 3 R 3.35 R - 0.61 = 0.56 = 40.00 = 0.61 R = 41.78 R - 0.61 ® 0.56 4.38 = 26.00 0.61 R = 32.16 U = .45 U = .52 VI/ Sa- ? o 2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MIN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date V / )+ / '`'l Site Address - q n n ? r U I t r- - Unit # Property Owner ylQ?le?Q1a_1S'eJti Telephone #((."5( ) 1ef?R- q?-- Contractor Dan Wohiers Southside Htg. & A/C 6950 W. 146' St., #106 Street Address Apple Valley, MN 55124 - C`Ty state (952) 431-7099 Telephone# ( ) Bond #: T2,1- ; 05q *-7 q eS-7 Expires: CIS a ? d ? The Applicant is Owner X Contractor Other Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling unit $ 50.00 furnace -Additional Replacement _ New air exchanger air conditioner heat pump other State Surcharge $ .50 Total $ I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name pphcant's Signature t F 4 * City of Eapn 3630 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Root 0 S Nnr III m i o i g iL -ForO--ff ic--eUs-e ----------- ? ? (3q j Permit#: Persil Fee: ,2'Y6,, AS Date Received: /toy x,30 j Staff: --------------- 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Cda j 7-3 Date: ?P O Site Address: (74D S[L1//G. (3YGL- Gi2LrL- Suite #: RESIDEN IOWNER Name: J>A-11f f? LLFI-T(-('? EP,4a Phone: 62Y-I- (Oge- 2-YV Address / City / Zip: ('l 4 C% ,1 L ??/L. &E4L &i?ef L . L-,410#41V , v+-fin/ SS'(Zc. Applicant is: -Owner Contractor 1x-tTL' A-T L- TYPE OF WORK Description of work: (wjcyGL p?isfc /r9 win! y?CW? P.?'Trci Lpp? ?PLAL? rt wf i Cr/?N E? ?s4/ H e°L-iJ w( J&I /U 0 7 Multi-Family Building: (Yes _ / No Construction Cost: 7 Sold • " 10 CONTRACTOR Name: )dr I-- 5F& 11 / /y C- License #: 7_0 y7 I (? 9 Address: 1 fS' A-Pl9pYLe+Cj, HLQ/V _TU2?Ar-l L. City: ?V LLL C I"Q State: Mf'Nj Zip: S-S_C)( 8 Phone: /_ 7?3 ``-/ 714//Contact Person: 6,016&".e COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 - Minnesota Rules 7670 Category 1 _ Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (J submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer $ Water Contractor: Phone: , : Plans and supporting documents that you submit are considered to be public information. Portions of NOT the formation may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the CIty of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in .accordance with the approved plan in the case of work which requires a review and approval of plans. ?+ x WrLGr? A16e12--&4A?21?x JA 9_/\J2 -?1 Applicant's Printed Name Applicants Signatty Page 1 of 3 A. DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool Single Family ? 06-piex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? 08-plex ? Deck ? Porch (screen/gazebo/pergola) ? Multi Misc. ? 03-Plex ? 10-plex ? Lower Level ? Storm Damage ? 04-Plex ? 12-plex ? Miscellaneous WORK TYPES ? New ? Interior Improvement ? Siding ? Demolish Building' ? Addition ? Move Bu ilding ? Reroof ? Demolish Interior ,Y7 Alteration ? Fire Repair No Windows ? Demolish Foundation ? Replacement ? Egress Window ? Water Damage ' Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation 6j, (Q 6 Occupancy S2C_ i MCES System Plan Review Code Edition ZOn'-7 SAC Units (25%_ too%_) Zoning ?, ^ I City Water Census Cade Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Const. Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock _ Footings (deck) Final/C. O. _ Footings (addition) Final/No C.O. Foundation HVAC Drain Tile Other: _ Roof:-Ice&Water -Final Pool: -Footings ,Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace:-R.I. _AirTest Final Windows - _ Insulation Retaining Wall //// Reviewed By-.-- YV/?/ Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total 1t3iA7ow5 -w012 1z,eMoDe? 3, 06,0. 00 6 D401 o0 ?j e0e .ma Page 2 of 3 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1790 Silver Bell Cir Lot: 5 Block: 3 Addition: Cedar Grove 1 lth PID:10- 16711 - 050 -03 Use: Description: Sub Type: e - Fixtures Work Type: New Description: Main Floor Meter Size Meter Type Comments: Permit closed Fee Summary: Contractor: Matthew Daniels 15230 Carousel Way Rosemount MN 55068 (651) 423 -3730 matthew huntington PL - Permit Fee (miscellaneous) Surcharge -Fixed Total: Manufacturer I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: David J Paulsen 1790 Silver Bell Cir Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: Serial Number Remote Number hout required inspection(s). Letter sent to applicant on 4/3/2009. (pf) $50.00 0801.4087 $0.50 9001.2195 Issued By: Signature Plumbing EA084777 07/30/2008 ePermit Line Size City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1790 Silver Bell Cir Lot: 5 Block: 3 Addition: Cedar Grove 1 lth PID:10- 16711 - 050 -03 Use: Description: Sub Type: e- Reroof Work Type: Replace Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Comments: If there is no ice protection inspec acceptable in lieu of inspections. Fee Summary: Valuation: 3,000.00 Contractor: New Life Contracting Inc. 2478 Hillwood Dr E Maplewood MN 55119 (651) 274 -6943 PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: Applicant/Permitee: Signature - Applicant - Construction Type: Occupancy: Permit Type: Permit Number: Date Issued: Permit Category: on prior to final, you must meet inspector with ladder and flat bar. Pictures are not Owner: David J Paulsen 1790 Silver Bell Cir Eagan MN 55122 $88.50 0801.4085 $1.50 9001.2195 $90.00 Issued By: Signature Building EA087626 12/02/2008 ePermit I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State CityofEaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 For Office Use Permit #: Permit Fee: Date Received: Staff: 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: WO- Site Address: ICC) ✓ 1 \ kit( 611 C- I Tenant: \C\) Pak., .1`7-L l'`l J RESIDENT /.OWNER, Suite #: Name: 1) AliPhone: I DC)1 ' (l''t ° q jig L} Address / City / Zip:1 fa 1 -%+ VC' 1 ?7* 1 I x`312-2. TYPE OF WOR Name: Address: 14105 Rutgers St. NE City: Prior Lake, MN bb3/2 State: Appliance Installers of MN, Inc. License #:4T.' Zip: Phone: C)2 141. C1 -`Cel 1 Contact: 1� 1 (Alf' (' nain Email: _ New )( Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Tumaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.oro I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pans. x (eel Applicant'Applicant14 Printed Name FOR OFFICE USE Required Inspections: t nderGround Rough -In Air:Tes x i Applicant's Signre PERMIT City of Eagan Permit Type:Building Permit Number:EA116157 Date Issued:10/03/2013 Permit Category:ePermit Site Address: 1790 Silver Bell Cir Lot:5 Block: 3 Addition: Cedar Grove 11th PID:10-16711-03-050 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - David J Paulsen 1790 Silver Bell Cir Eagan MN 55122 Great Northern Builders 9419 Buckley Ct Inver Grove Heights MN 55077 (651) 436-5672 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA136033 Date Issued:04/20/2016 Permit Category:ePermit Site Address: 1790 Silver Bell Cir Lot:5 Block: 3 Addition: Cedar Grove 11th PID:10-16711-03-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - David J Paulsen 1790 Silver Bell Cir Eagan MN 55122 (651) 688-9244 Home Depot At Home Services 6224 Lakeland Avenue N, #102 Booklyn Park MN 55428 (763) 542-8826 Applicant/Permitee: Signature Issued By: Signature